ASPECTS OF THE INTESTINAL BACTERIAL ECOSY STEM IN RELATION WITH PERITONITIS TREATMENT

Bacteria that cause peritonitis originate in the intestinal tract. The intestinal flora comprises several hundreds of bacterial species and is very stable in the basal state. However, its composition can be sha rply changed following antimicrobial treatments. These modifications c an lead to the selection and multiplication of multiresistant clones a mong the potentially most pathogenic species, such as enterobacteria a nd enterococci. This leads to two risks, the first being the occurence of an infection in the colonized patient, the second being the occure nce of nosocomial infections in other patients of the unit due to feca l dissemination. These two risk should be assessed when empiric antimi crobial treatments are initiated.